Tick-borne encephalitis (TBE) is a substantial public health problem in many parts of Europe and Asia. To assess the effect of increasing TBE vaccination coverage in Austria, we compared incidence rates over 40 years for highly TBE-endemic countries of central Europe (Czech Republic, Slovenia, and Austria). For all 3 countries we found extensive annual and longer range fluctuations and shifts in distribution of patient ages, suggesting major variations in the complex interplay of factors influencing risk for exposure to TBE virus. The most distinctive effect was found for Austria, where mass vaccination decreased incidence to ≈16% of that of the prevaccination era. Incidence rates remained high for the nonvaccinated population. The vaccine was effective for persons in all age groups. During 2000-2011 in Austria, ≈4,000 cases of TBE were prevented by vaccination.

Department of Virology Medical University of Vienna Vienna Austria

Zobrazit více v PubMed

World Health Organization. Vaccines against tick-borne encephalitis: WHO position paper. Wkly Epidemiol Rec. 2011;86:241–56. PubMed

Centers for Disease Control and Prevention. Tick-borne encephalitis among U.S. travelers to Europe and Asia—2000–2009. MMWR Morb Mortal Wkly Rep. 2010;59:335–8. PubMed

Reusken C, Reimerink J, Verduin C, Sabbe L, Cleton N, Koopmans M. Case report: tick-borne encephalitis in two Dutch travellers returning from Austria, Netherlands, July and August 2011. Euro Surveill. 2011;16:20003. PubMed

Simmonds P, Becher P, Collett MS, Gould EA, Heinz FX, Meyers G, et al. Family Flaviviridae. In: King AMQ, Lefkowitz E, Adams MJ, Carstens EB, editors. Virus taxonomy. IXth Report of the International Committee on Taxonomy of Viruses. San Diego: Elsevier Academic Press; 2011.

Lindquist L, Vapalahti O. Tick-borne encephalitis. Lancet. 2008;371:1861–71. 10.1016/S0140-6736(08)60800-4 PubMed DOI

Süss J. Tick-borne encephalitis 2010: epidemiology, risk areas, and virus strains in Europe and Asia—an overview. Ticks Tick Borne Dis. 2011;2:2–15. PubMed

Růžek D, Dobler G, Donoso Mantke O. Tick-borne encephalitis: pathogenesis and clinical implications. Travel Med Infect Dis. 2010;8:223–32. 10.1016/j.tmaid.2010.06.004 PubMed DOI

Korenberg EI. Chapter 4. Recent epidemiology of tick-borne encephalitis an effect of climate change? Adv Virus Res. 2009;74:123–44 and. 10.1016/S0065-3527(09)74004-7 PubMed DOI

Zeman P. Objective assessment of risk maps of tick-borne encephalitis and Lyme borreliosis based on spatial patterns of located cases. Int J Epidemiol. 1997;26:1121–9. 10.1093/ije/26.5.1121 PubMed DOI

Randolph SE, Green RM, Peacey MF, Rogers DJ. Seasonal synchrony: the key to tick-borne encephalitis foci identified by satellite data. Parasitology. 2000;121:15–23. 10.1017/S0031182099006083 PubMed DOI

Daniel M, Benes C, Danielova V, Kriz B. Sixty years of research of tick-borne encephalitis—a basis of the current knowledge of the epidemiological situation in central Europe. Epidemiol Mikrobiol Imunol. 2011;60:135–55. PubMed

Gubler D, Kuno G, Markhoff L. Flaviviruses. In: Knipe DM, Howley PM, Griffin DE, Lamb RA, Martin MA, Roizman B, et al., editors. Fields virology. 5th ed. Philadelphia: Lippincott Williams & Wilkins; 2007. p. 1153–252.

Kaiser R. The clinical and epidemiological profile of tick-borne encephalitis in southern Germany 1994–98: a prospective study of 656 patients. Brain. 1999;122:2067–78. 10.1093/brain/122.11.2067 PubMed DOI

Kunze U. Conference report of the 10th meeting of the International Scientific Working Group on Tick-borne Encephalitis (ISW-TBE): combating tick-borne encephalitis: vaccination rates on the rise. Vaccine. 2008;26:6738–40. 10.1016/j.vaccine.2008.10.059 PubMed DOI

Grgic-Vitek M, Klavs I. Low coverage and predictors of vaccination uptake against tick-borne encephalitis in Slovenia. Eur J Public Health. Epub 2011 Mar 11. PubMed PMC

Orlinger KK, Hofmeister Y, Fritz R, Holzer GW, Falkner FG, Unger B, et al. A tick-borne encephalitis virus vaccine based on the European prototype strain induces broadly reactive cross-neutralizing antibodies in humans. J Infect Dis. 2011;203:1556–64. 10.1093/infdis/jir122 PubMed DOI

Fritz R, Orlinger KK, Hofmeister Y, Janecki K, Traweger A, Perez-Burgos L, et al. Quantitative comparison of the cross-protection induced by tick-borne encephalitis virus vaccines based on European and Far Eastern virus subtypes. Vaccine. 2012;30:1165–9. 10.1016/j.vaccine.2011.12.013 PubMed DOI

Sumilo D, Asokliene L, Bormane A, Vasilenko V, Golovljova I, Randolph SE. Climate change cannot explain the upsurge of tick-borne encephalitis in the Baltics. PLoS ONE. 2007;2:e500. 10.1371/journal.pone.0000500 PubMed DOI PMC

Tokarevich NK, Tronin AA, Blinova OV, Buzinov RV, Boltenkov VP, Yurasova ED, et al. The impact of climate change on the expansion of Ixodes persulcatus habitat and the incidence of tick-borne encephalitis in the north of European Russia. Glob Health Action. 2011;4:8448. PubMed PMC

Daniel M, Kriz B, Danielova V, Valter J, Benes C. Changes of meteorological factors and tick-borne encephalitis incidence in the Czech Republic. Epidemiol Mikrobiol Imunol. 2009;58:179–87 . PubMed

Barrett PN, Plotkin SA, Ehrlich HJ. Tick-borne encephalitis virus vaccines. In: Plotkin SA, Orenstein WA, Offit PA, editors. Vaccines. 5th ed. Philadelphia; Saunders Elsevier; 2008. p. 841–56.

Loew-Baselli A, Poellabauer EM, Pavlova BG, Fritsch S, Firth C, Petermann R, et al. Prevention of tick-borne encephalitis by FSME-IMMUN vaccines: review of a clinical development programme. Vaccine. 2011;29:7307–19. 10.1016/j.vaccine.2011.07.089 PubMed DOI

Wittermann C, Petri E, Zent O. Long-term persistence of tick-borne encephalitis antibodies in children 5 years after first booster vaccination with Encepur® Children. Vaccine. 2009;27:1585–8. 10.1016/j.vaccine.2008.12.057 PubMed DOI

Heinz FX, Holzmann H, Essl A, Kundi M. Field effectiveness of vaccination against tick-borne encephalitis. Vaccine. 2007;25:7559–67. 10.1016/j.vaccine.2007.08.024 PubMed DOI

Grgič-Vitek M, Klavs I. High burden of tick-borne encephalitis in Slovenia—challenge for vaccination policy. Vaccine. 2011;29:5178–83. 10.1016/j.vaccine.2011.05.033 PubMed DOI

Kunz C. TBE vaccination and the Austrian experience. Vaccine. 2003;21(Suppl 1):S50–5. 10.1016/S0264-410X(02)00813-7 PubMed DOI

Stiasny K, Holzmann H, Heinz FX. Characteristics of antibody responses in tick-borne encephalitis vaccination breakthroughs. Vaccine. 2009;27:7021–6. 10.1016/j.vaccine.2009.09.069 PubMed DOI

Weinberger B, Keller M, Fischer KH, Stiasny K, Neuner C, Heinz FX, et al. Decreased antibody titers and booster responses in tick-borne encephalitis vaccinees aged 50–90 years. Vaccine. 2010;28:3511–5. 10.1016/j.vaccine.2010.03.024 PubMed DOI

Labuda M, Jones LD, Williams T, Danielova V, Nuttall PA. Efficient transmission of tick-borne encephalitis virus between cofeeding ticks. J Med Entomol. 1993;30:295–9. PubMed

Randolph SE. Transmission of tick-borne pathogens between co-feeding ticks: Milan Labuda's enduring paradigm. Ticks Tick Borne Dis. 2011;2:179–82. PubMed

Stanek G, Wormser GP, Gray J, Strle F. Lyme borreliosis. Lancet. 2012;379:461–73. 10.1016/S0140-6736(11)60103-7 PubMed DOI

Suss J. Tick-borne encephalitis in Europe and beyond—the epidemiological situation as of 2007. Euro Surveill. 2008;13:18916. PubMed

Karelis G, Bormane A, Logina I, Lucenko I, Suna N, Krumina A, et al. Tick-borne encephalitis in Latvia 1973–2009: epidemiology, clinical features and sequelae. Eur J Neurol. 2012;19:62–8. 10.1111/j.1468-1331.2011.03434.x PubMed DOI

Stiasny K, Aberle JH, Keller M, Grubeck-Loebenstein B, Heinz FX. Age affects quantity but not quality of antibody responses after vaccination with an inactivated flavivirus vaccine against tick-borne encephalitis. PLoS ONE. 2012;7:e34145. 10.1371/journal.pone.0034145 PubMed DOI PMC

Spatiotemporal spread of tick-borne encephalitis in the EU/EEA, 2012 to 2020

Clinical Characteristics of Patients with Tick-Borne Encephalitis (TBE): A European Multicentre Study from 2010 to 2017

Catalogue of stage-specific transcripts in Ixodes ricinus and their potential functions during the tick life-cycle

Increased Relative Risk of Tick-Borne Encephalitis in Warmer Weather

Cyclic patterns in the central European tick-borne encephalitis incidence series

Human CD4+ T Helper Cell Responses after Tick-Borne Encephalitis Vaccination and Infection

Nucleoside inhibitors of tick-borne encephalitis virus

Clinical course and sequelae for tick-borne encephalitis among children in South Moravia (Czech Republic)

Ixodes ricinus and Its Transmitted Pathogens in Urban and Peri-Urban Areas in Europe: New Hazards and Relevance for Public Health

Variation of the specificity of the human antibody responses after tick-borne encephalitis virus infection and vaccination